Individual provider Active NPI

Mayrabeth Atilano Collazo

  • Registered Nurse
  • Anasco, PR
National Provider Identifier
1558025239
Registry record updated Oct 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
091559 Issued in PR
Practice address
Carretera 405 KM 2.4
Barrio Carreras
Anasco, PR 00610-9057
Phone
(970) 402-1284
NPI assigned
Oct 28, 2021
Last updated
Oct 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 091559 PR Primary

Addresses

Primary practice location

Carretera 405 KM 2.4
Barrio Carreras
Anasco, PR 00610-9057

Mailing address

RR 4 Box 5602
Anasco, PR 00610-9057
Phone (970) 402-1284

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
091559PRMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1635379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1558025239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 4 BOX 5602",
            "city": "ANASCO",
            "state": "PR",
            "postal_code": "006109057",
            "telephone_number": "970-402-1284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARRETERA 405 KM 2.4",
            "address_2": "BARRIO CARRERAS",
            "city": "ANASCO",
            "state": "PR",
            "postal_code": "006109057",
            "telephone_number": "970-402-1284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATILANO COLLAZO",
        "first_name": "MAYRABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-28",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PR",
            "license": "091559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anasco, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.